<html>
 <head>
  <title>New Credentials Entry Page</title>
 <link rel="stylesheet" href="../css/jquery.mobile-1.3.2.min.css" />
    <script type="text/javascript"  src="../js/jquery-1.10.2.min.js"></script>
    <script type="text/javascript" src="../js/jquery.mobile-1.3.2.min.js"></script>
	<script type="text/javascript">
	function submitInfo(){
	
		if(!($('#registrationName').val()=="" || $('#registrationContact').val()=="" || $('#EnterQuestion1').val()=="" || 
		$('#registrationSecurityAns1').val()=="" || $('#EnterQuestion2').val()=="" || $('#registrationSecurityAns2').val()=="")){
			var frm = document.getElementById('myFormRegistration');
		frm.submit();
		}else{
			alert('Please fill all required fields...');
		}
	
	}
	</script>
  <style>
  
.ui-page, .ui-mobile-viewport {
	background: url(../css/images/tiling_stripes.gif);
}
h1{
margin-bottom: -1%;
margin-top: -0.5%;
}
.tableTitles{
text-align:center;
font-weight:bold;

}
.ui-select{
	width:100%;
}
  #searchContainerDivId{
  margin-left: 24%;
  }
  </style>
 </head>
 <body>
  <div data-role="page" id="home">  
   <div data-position="fixed" data-role="header" data-theme="b">   
    <h1>  
     Registration page
    </h1>  
   </div>  
   <div align="center" data-role="content">
    <form action="dddd" method="POST" id="myFormRegistration">
    
     <div id="tableContainerRegistrationDivId">
      <table border="0" style="width:80%;">
       <tr>
        <td class="tableTitles">Full Name</td>
        <td class="textBoxClass"><input id="registrationName" name="" type="text" placeholder="Enter Name" required/></td>
       </tr>
       <tr>
        <td class="tableTitles">Address</td>
        <td class="textBoxClass"><textarea id="registrationAddress" name="" required></textarea></td>
       </tr>
       <tr>
        <td class="tableTitles">Contact No.</td>
        <td class="textBoxClass"><input id="registrationContact" name="" type="text" placeholder="Contact" required/></td>
       </tr>
       <tr>
        <td class="tableTitles">Email Id </td>
        <td class="textBoxClass"><input id="registrationEmail" name="" type="text" placeholder="abc.cdf@xyz.com"/></td>
       </tr>
       <tr>
        <td class="tableTitles">Security Question 1</td>
        <td class="textBoxClass"><input id="EnterQuestion1" name="" type="text" placeholder="Enter any question?" required/>
        </td>
       </tr>
       <tr>
        <td class="tableTitles">Answer 1</td>
        <td class="textBoxClass"><input id="registrationSecurityAns1" name="" type="text" placeholder="Enter answer for your question..." required/></td>
       </tr>
       <tr>
        <td class="tableTitles">Security Question 2</td>
        <td class="textBoxClass"><input id="EnterQuestion2" name="" type="text" placeholder="Enter any question?" required/>
		</td>
       </tr> 
       <tr>
        <td class="tableTitles">Answer 2</td>
        <td class="textBoxClass"><input id="registrationSecurityAns2" name="" type="text" placeholder="Enter answer for your question..." required/></td>
       </tr>
      </table>
     </div>
		<div id="saveInfoButtonDivId" style="width:35%;" >
     <button id="saveInfoButtonId"  data-theme="a" onClick="submitInfo();">save Information</button>
    </div>
    </form>
   </div>
  </div>
    </body>
</html>